Remote A​/R Follow-up Manager - AI Trainer

Patient Accounts Specialist

We are looking for a full-time Patient Accounts Specialist to work in a fast‑paced hospital business office. The position is responsible for collections on assigned patient accounts by contacting patients, insurance companies, and third‑party payors to resolve outstanding balances and reconcile account receivables and contractuals. The role also involves financial counseling of patients and families, verifying insurance information within one business day of admission, and ensuring adherence to department quality and productivity standards.

Additional compensation is available for achieving established team collection goals.

Patient Accounts Collection:

• Identify and resolve claim delay issues that impact collections.
• Follow up on payment errors, low reimbursement, and denials.
• Accurately interpret Explanation of Benefits (EOB).
• Initiate and track all appeals and reconsiderations as necessary.
• Resolve incarceration, third‑party liability, and coordination of benefits (COB) discrepancies.
• Work directly with insurance companies, providers, and patients to get claims processed and paid.
• Utilize insurance company provider portals, online chat systems, and IVR phone systems for claim resolution efforts.

Financial Counseling and Payment Coordination:

• Utilize knowledge of healthcare reimbursement, medical insurance, and negotiating payment terms.
• Effectively determine and communicate insurance benefits and patient self‑pay responsibilities to patient/guarantor pre‑admission.
• Monitor and review all new accounts and follow‑up documents to ensure accuracy and completion of information received from the Intake (A&R) Department.
• Contact all payors to clarify insurance benefits and provide benefit education to patients, parents, and guarantors.
• Meet with patients/guarantors in lobby and on treatment units to obtain upfront deposits, set up payment plans, and complete financial paperwork.
• Maintain daily upfront collection spreadsheet.
• Investigate delinquent patient information by timely contact with third‑party payor organizations and/or patients to identify special circumstances affecting billing delays and to ensure billing credibility.
• Prepare and maintain records and reports documenting the status of insurance verification and upfront payment collections.

Additional Responsibilities:

• Create an exceptional customer experience when handling inbound and outbound customer service calls efficiently while empathizing with customers and navigating systems in a fast‑paced environment.
• Document detailed notes regarding all actions with appropriate message codes.
• Maintain current knowledge of all insurance verification policies, procedures, and related legislation.
• Notify the Business Office Director of any delinquent information.
• Promote a positive working environment and guest relations.
• Promote safety by attending mandatory in‑services and complying with all safety measures initiated by the facility.
• Assume and/or perform additional duties as requested.

To perform this job successfully, an individual must be able to demonstrate competency in the criteria listed below. Successful completion of a background check and drug screen is required for employment at Cedar Springs Hospital.

Requirements:

• Ability to work independently and as part of a team.
• Experience with medical insurance.
• Working knowledge of Medicare/Medicaid regulations, policies, and procedures.
• Strong customer service, written/verbal, organizational, and interpersonal skills.
• Computer literate with strong skills in Microsoft Word and Excel.
• Ability to maintain patient confidentiality.
• Ability to exercise independent judgment to accomplish goals and manage time efficiently to meet multiple deadlines.
• Successful completion of a background check and drug screen required for employment at Cedar Springs Hospital.

Education/

Experience:

• High school education or equivalent.
• Minimum of one (1) year experience in health‑care collections or related field, or any combination of education, training, or experience in a health‑care business office environment.